flecainide effects

[Jimbobarelli]

initially I was prescribed 200mh PiP for my PAF. When my episodes become every two weeks, I was given 2x100my daily ( plus the 200mg pip for every episode .

the daily doses don’t seem to have really had any effect in reducing in the episodes .

What I have noticed is that now - when I transition from stationary to moving - I sense palpitations as if my heart is struggling to adapt from one state to the other . Initially this was when I was exercising - I do sessions of two minutes exercising two minutes rest - and for the first few minutes my heart struggled to find a rhythm . This then passes and it becomes more normal - ie the hard two minutes get up up to 125 etc , the recovery back to 90 odd and so on.

now however it’s occurring doing what I would say is non- exercise activity . Yesterday at the driving range it went full AF … but I sat down and within 5 minutes returned to normal without any tablets etc . It happened again after laying on the floor for twenty minutes and then getting up quickly and running up the stairs . I am very fit … my resting pulse is 40 odd. I experience no pain or breathlessness during PAF - just the palpitations and irregular beats.

Question- could the flecainide make my heart less responsive to the change in activity levels ? I’m wondering if the daily amounts arent making PAF any less frequent , what’s the point of taking them ?

[Cliff_G]

Jim, with a resting heart rate of 40 and assuming you're not on beta blockers, your AF is likely to be "vagal". This sub-type does affect the triggers and what is best to do in response. Have a good search around, you'll find lots.

And if you are on BBs and are vagal, then the BBs can actually make fib episodes more likely.

[BobD Volunteer]

Do be aware that the maximum daily (24 hours) dose of flecainide is 300mg so you are in danger of ODing which could be dangerous and may in fact be a cause of some of your problems.

[Jimbobarelli in reply to BobD]

I’ve never taken more than 300 in a day

[mjames1]

Have you documented these recent episodes with an EKG to differentiate from arrhythmias other than afib such as flutter or even ectopics? As to the point of taking Flecainide, is your quality of life any better on it versus off? If not, then it's not working for you.. Have you looked into ablation?

Jim

[OzJames]

it may be ectopics which i get sometimes with AF mine settle after a few days and i practice mindful nose breathing for 5 mins 4 times a day. Sit in the garden or in a quiet room and listen to your breath

[Shcldavies]

From my experience there are 2 potential reasons:

1. Your resting HR may be too low, your heart is good at fixing itself and when it senses too low a rate it temporarily converts normal muscle cells to signal cells to increase the rate thus potentially causing abnormal HR.

2. Too much medication or incorrect medication can be worst than too low/no medication.

How these can be fixed is very unique to you so I would not dare offer any potential fixes, however I believe it’s well worth discussing with Doc.

[secondtry]

Try humming as soon as your episode starts. I have just started this recently and it seems to work well, even my cardiologist gave it a nod of approval; helps the Vagus Nerve. More homework on low HR/VN, is almost certainly relevant at 40.

Sounds like your heart is still unstable. I would keep a diary to take to your next medic appointment. I would also say Flecainide may take 3 months to 'settle in'.

Lastly at the outset of my AF life, I cut all exercise and amazingly felt an episode coming on with just a short walk and also sitting down to relax at the end of the day. Now moderate exercise or rest is no problem. In general, I find the more I am engaged and active there is no reduction in QOL but relax and think about it/other concerns and off it starts 😬.

[Pommerania78 in reply to secondtry]

Why do you think Flecainide takes several months to have full effect? Thanks.

[secondtry in reply to Pommerania78]

Its a long time ago since I started on Flec but I recall feeling rather strange for 3 months.

[Pommerania78 in reply to secondtry]

The same thing happened to me. In fact, I could feel my heart struggling with it for a month or so with "cramps". At least that is how it felt to me. But WHY do you think it takes so long for it to have an effect? I'm just curious. This is why, as I mentioned to you in an earlier message, that it may be the Flecainide itself which is causing your problems. But, I'm just a layman being curious. Obviously your cardiologist knows more than me. Thanks.

[Pommerania78 in reply to secondtry]

Just had another thought. Is it possible that you have gotten a "bad" batch of Flecainide recently? Maybe from a bad company in China or India? In the United States the government recently has had to stop some Indian companies from making certain drugs because of poor/negligent production. Could you get your Flecainide from a different production company as an experiment? Thanks.

[secondtry in reply to Pommerania78]

Thanks for the suggestion, I know what you mean I decided not to order Ivermectin from India due to quality concerns. However on Flecainide I have always had the same brand 'Accord' manufactured in UK.

[BeeBee79]

Flecanide sent my AF into a tailspin and I was quickly taken off them. They also did something life threatening but can’t confirm the link - if they don’t agree with you, email your cardiologist’s nurse and pass on the message of how they make you feel.

Hope you get it sorted ✔️

[Vonnegut]

The maximum daily dose of Flecainide is 300mg!! You are sometimes exceeding that it seems!

[moleman37]

Jim, flecainide has been good for me so far in the 4+ months I've been taking it. I have similar resting heart rate in 40's and now back to my pre-AFIB activity levels. Initially prescribed 50 mg flecainide 2X/day. It worked for about 6 weeks but again started having multiple AFIB episodes. Electrophysiologist agreed with my request to increase to 75 mg 2X/day. Since then, it's been all good and currently on the longest stretch of NSR to date. So, to answer your question flecainide doesn't appear to make my heart less responsive to changes in activity level and so far I tolerate it well and amazed that little white pill helps still my heart.